| Payment ID | 24090 |
|---|---|
| Date Created | 04/25/23 4:19 pm |
| Created By | Gloria Jimenez |
| Service Request | 23726 |
| Application ID | 17313 |
| Authorization Number | |
| Applicant Information | |
| Name | Dewayne Ricks |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171101285 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Motel 6 Waco |
| Location Contact Name | Laurel |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 1 |
| From | 04/26/2023 |
| To | 05/03/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $750.00 |
| Receipt Amount | $541.58 |
| Receipt Date | 04/25/2023 |
| Comments | hotel stay at Motel 6 departure date is 05/03/23 |
| Receipt | 25-04-2023Ricks541.58.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/25/2023 |
Housing Stability Services Program
Available 24/7
Housing Stability Services Program
Available 24/7
Funded by Texas Department of Housing and Community Affairs
Funded by Texas Department of Housing and Community Affairs